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Folloni D, Fouragnan E, Wittmann MK, Roumazeilles L, Tankelevitch L, Verhagen L, Attali D, Aubry JF, Sallet J, Rushworth MFS. Ultrasound modulation of macaque prefrontal cortex selectively alters credit assignment-related activity and behavior. SCIENCE ADVANCES 2021; 7:eabg7700. [PMID: 34910510 PMCID: PMC8673758 DOI: 10.1126/sciadv.abg7700] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 10/28/2021] [Indexed: 05/30/2023]
Abstract
Credit assignment is the association of specific instances of reward to the specific events, such as a particular choice, that caused them. Without credit assignment, choice values reflect an approximate estimate of how good the environment was when the choice was made—the global reward state—rather than exactly which outcome the choice caused. Combined transcranial ultrasound stimulation (TUS) and functional magnetic resonance imaging in macaques demonstrate credit assignment–related activity in prefrontal area 47/12o, and when this signal was disrupted with TUS, choice value representations across the brain were impaired. As a consequence, behavior was no longer guided by choice value, and decision-making was poorer. By contrast, global reward state–related activity in the adjacent anterior insula remained intact and determined decision-making after prefrontal disruption.
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Affiliation(s)
- Davide Folloni
- Wellcome Centre for Integrative Neuroimaging (WIN), Department of Experimental Psychology, Tinsley Building, Mansfield Road, Oxford OX1 3TA, University of Oxford, Oxford, UK
| | - Elsa Fouragnan
- Wellcome Centre for Integrative Neuroimaging (WIN), Department of Experimental Psychology, Tinsley Building, Mansfield Road, Oxford OX1 3TA, University of Oxford, Oxford, UK
- School of Psychology, University of Plymouth, Plymouth, UK
| | - Marco K. Wittmann
- Wellcome Centre for Integrative Neuroimaging (WIN), Department of Experimental Psychology, Tinsley Building, Mansfield Road, Oxford OX1 3TA, University of Oxford, Oxford, UK
| | - Lea Roumazeilles
- Wellcome Centre for Integrative Neuroimaging (WIN), Department of Experimental Psychology, Tinsley Building, Mansfield Road, Oxford OX1 3TA, University of Oxford, Oxford, UK
| | - Lev Tankelevitch
- Wellcome Centre for Integrative Neuroimaging (WIN), Department of Experimental Psychology, Tinsley Building, Mansfield Road, Oxford OX1 3TA, University of Oxford, Oxford, UK
| | - Lennart Verhagen
- Wellcome Centre for Integrative Neuroimaging (WIN), Department of Experimental Psychology, Tinsley Building, Mansfield Road, Oxford OX1 3TA, University of Oxford, Oxford, UK
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, 6525 HR, Netherlands
| | - David Attali
- Physics for Medicine Paris, ESPCI Paris, INSERM, CNRS, PSL Research University, Paris, France
- GHU PARIS Psychiatrie and Neurosciences, site Sainte-Anne, Service Hospitalo-Universitaire, Pôle Hospitalo-Universitaire, Paris 15, F-75014 Paris, France
- Université de Paris, F-75005 Paris, France
| | - Jean-François Aubry
- Physics for Medicine Paris, ESPCI Paris, INSERM, CNRS, PSL Research University, Paris, France
| | - Jerome Sallet
- Wellcome Centre for Integrative Neuroimaging (WIN), Department of Experimental Psychology, Tinsley Building, Mansfield Road, Oxford OX1 3TA, University of Oxford, Oxford, UK
- Université Lyon 1, Inserm, Stem Cell and Brain Research Institute U1208, 18 Avenue Doyen Lepine, 69500 Bron, France
| | - Matthew F. S. Rushworth
- Wellcome Centre for Integrative Neuroimaging (WIN), Department of Experimental Psychology, Tinsley Building, Mansfield Road, Oxford OX1 3TA, University of Oxford, Oxford, UK
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Chen Y, Li Y, Du M, Yu J, Gao F, Yuan Z, Chen Z. Ultrasound Neuromodulation: Integrating Medicine and Engineering for Neurological Disease Treatment. BIO INTEGRATION 2021. [DOI: 10.15212/bioi-2020-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Abstract Neurological diseases associated with dysfunctions of neural circuits, including Alzheimer’s disease (AD), depression and epilepsy, have been increasingly prevalent. To tackle these issues, artificial stimulation or regulation of specific neural circuits and
nuclei are employed to alleviate or cure certain neurological diseases. In particular, ultrasound neuromodulation has been an emerging interdisciplinary approach, which integrates medicine and engineering methodologies in the treatment. With the development of medicine and engineering, ultrasound
neuromodulation has gradually been applied in the treatment of central nervous system diseases. In this review, we aimed to summarize the mechanism of ultrasound neuromodulation and the advances of focused ultrasound (FUS) in neuromodulation in recent years, with a special emphasis on its
application in central nervous system disease treatment. FUS showed great feasibility in the treatment of epilepsy, tremor, AD, depression, and brain trauma. We also suggested future directions of ultrasound neuromodulation in clinical settings, with a focus on its fusion with genetic engineering
or nanotechnology.
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Affiliation(s)
- Yuhao Chen
- Department of Ultrasound Medicine, Laboratory of Ultrasound Molecular Imaging, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - Yue Li
- Department of Ultrasound Medicine, Laboratory of Ultrasound Molecular Imaging, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - Meng Du
- Medical Imaging Centre, First Affiliated Hospital of University of South China, Hengyang, Hunan 421001, China
| | - Jinsui Yu
- Department of Ultrasound Medicine, Laboratory of Ultrasound Molecular Imaging, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - Fei Gao
- Cancer Center, Faculty of Health Sciences, Centre for Cognitive and Brain Sciences, University of Macau, Macau SAR 999078, China
| | - Zhen Yuan
- Cancer Center, Faculty of Health Sciences, Centre for Cognitive and Brain Sciences, University of Macau, Macau SAR 999078, China
| | - Zhiyi Chen
- Medical Imaging Centre, First Affiliated Hospital of University of South China, Hengyang, Hunan 421001, China
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53
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Zhang T, Pan N, Wang Y, Liu C, Hu S. Transcranial Focused Ultrasound Neuromodulation: A Review of the Excitatory and Inhibitory Effects on Brain Activity in Human and Animals. Front Hum Neurosci 2021; 15:749162. [PMID: 34650419 PMCID: PMC8507972 DOI: 10.3389/fnhum.2021.749162] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/06/2021] [Indexed: 12/15/2022] Open
Abstract
Non-invasive neuromodulation technology is important for the treatment of brain diseases. The effects of focused ultrasound on neuronal activity have been investigated since the 1920s. Low intensity transcranial focused ultrasound (tFUS) can exert non-destructive mechanical pressure effects on cellular membranes and ion channels and has been shown to modulate the activity of peripheral nerves, spinal reflexes, the cortex, and even deep brain nuclei, such as the thalamus. It has obvious advantages in terms of security and spatial selectivity. This technology is considered to have broad application prospects in the treatment of neurodegenerative disorders and neuropsychiatric disorders. This review synthesizes animal and human research outcomes and offers an integrated description of the excitatory and inhibitory effects of tFUS in varying experimental and disease conditions.
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Affiliation(s)
- Tingting Zhang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Na Pan
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Yuping Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neuromodulation, Beijing, China
- Center of Epilepsy, Institute of Sleep and Consciousness Disorders, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Chunyan Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Shimin Hu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neuromodulation, Beijing, China
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Shi L, Jiang Y, Fernandez FR, Chen G, Lan L, Man HY, White JA, Cheng JX, Yang C. Non-genetic photoacoustic stimulation of single neurons by a tapered fiber optoacoustic emitter. LIGHT, SCIENCE & APPLICATIONS 2021; 10:143. [PMID: 34257273 PMCID: PMC8277806 DOI: 10.1038/s41377-021-00580-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/09/2021] [Accepted: 06/21/2021] [Indexed: 05/19/2023]
Abstract
Neuromodulation at high spatial resolution poses great significance in advancing fundamental knowledge in the field of neuroscience and offering novel clinical treatments. Here, we developed a tapered fiber optoacoustic emitter (TFOE) generating an ultrasound field with a high spatial precision of 39.6 µm, enabling optoacoustic activation of single neurons or subcellular structures, such as axons and dendrites. Temporally, a single acoustic pulse of sub-microsecond converted by the TFOE from a single laser pulse of 3 ns is shown as the shortest acoustic stimuli so far for successful neuron activation. The precise ultrasound generated by the TFOE enabled the integration of the optoacoustic stimulation with highly stable patch-clamp recording on single neurons. Direct measurements of the electrical response of single neurons to acoustic stimulation, which is difficult for conventional ultrasound stimulation, have been demonstrated. By coupling TFOE with ex vivo brain slice electrophysiology, we unveil cell-type-specific responses of excitatory and inhibitory neurons to acoustic stimulation. These results demonstrate that TFOE is a non-genetic single-cell and sub-cellular modulation technology, which could shed new insights into the mechanism of ultrasound neurostimulation.
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Affiliation(s)
- Linli Shi
- Department of Chemistry, Boston University, 580 Commonwealth Avenue, Boston, MA, 02215, USA
| | - Ying Jiang
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA, 02215, USA
| | - Fernando R Fernandez
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA, 02215, USA
- Center for Systems Neuroscience, Boston University, 610 Commonwealth Ave, Boston, MA, 02215, USA
- Neurophotonics Center, Photonics Center, Boston University, 8 St. Mary's Street, Boston, MA, 02215, USA
| | - Guo Chen
- Department of Electrical and Computer Engineering, 8 St. Mary's Street, Boston, MA, 02215, USA
| | - Lu Lan
- Department of Electrical and Computer Engineering, 8 St. Mary's Street, Boston, MA, 02215, USA
| | - Heng-Ye Man
- Center for Systems Neuroscience, Boston University, 610 Commonwealth Ave, Boston, MA, 02215, USA
- Department of Biology, Boston University, 5 Cummington Mall, Boston, MA, 02215, USA
| | - John A White
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA, 02215, USA
- Center for Systems Neuroscience, Boston University, 610 Commonwealth Ave, Boston, MA, 02215, USA
- Neurophotonics Center, Photonics Center, Boston University, 8 St. Mary's Street, Boston, MA, 02215, USA
| | - Ji-Xin Cheng
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, MA, 02215, USA.
- Department of Electrical and Computer Engineering, 8 St. Mary's Street, Boston, MA, 02215, USA.
| | - Chen Yang
- Department of Chemistry, Boston University, 580 Commonwealth Avenue, Boston, MA, 02215, USA.
- Department of Electrical and Computer Engineering, 8 St. Mary's Street, Boston, MA, 02215, USA.
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Therapies to Restore Consciousness in Patients with Severe Brain Injuries: A Gap Analysis and Future Directions. Neurocrit Care 2021; 35:68-85. [PMID: 34236624 PMCID: PMC8266715 DOI: 10.1007/s12028-021-01227-y] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 03/04/2021] [Indexed: 02/06/2023]
Abstract
Background/Objective For patients with disorders of consciousness (DoC) and their families, the search for new therapies has been a source of hope and frustration. Almost all clinical trials in patients with DoC have been limited by small sample sizes, lack of placebo groups, and use of heterogeneous outcome measures. As a result, few therapies have strong evidence to support their use; amantadine is the only therapy recommended by current clinical guidelines, specifically for patients with DoC caused by severe traumatic brain injury. To foster and advance development of consciousness-promoting therapies for patients with DoC, the Curing Coma Campaign convened a Coma Science Work Group to perform a gap analysis. Methods We consider five classes of therapies: (1) pharmacologic; (2) electromagnetic; (3) mechanical; (4) sensory; and (5) regenerative. For each class of therapy, we summarize the state of the science, identify gaps in knowledge, and suggest future directions for therapy development. Results Knowledge gaps in all five therapeutic classes can be attributed to the lack of: (1) a unifying conceptual framework for evaluating therapeutic mechanisms of action; (2) large-scale randomized controlled trials; and (3) pharmacodynamic biomarkers that measure subclinical therapeutic effects in early-phase trials. To address these gaps, we propose a precision medicine approach in which clinical trials selectively enroll patients based upon their physiological receptivity to targeted therapies, and therapeutic effects are measured by complementary behavioral, neuroimaging, and electrophysiologic endpoints. Conclusions This personalized approach can be realized through rigorous clinical trial design and international collaboration, both of which will be essential for advancing the development of new therapies and ultimately improving the lives of patients with DoC. Supplementary Information The online version contains supplementary material available at 10.1007/s12028-021-01227-y.
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56
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Chen H, Jerusalem A. A Framework for Low-Intensity Low-Frequency Ultrasound Neuromodulation Sonication Parameter Identification from Micromechanical Flexoelectricity Modelling. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:1985-1991. [PMID: 33820667 DOI: 10.1016/j.ultrasmedbio.2021.02.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 02/23/2021] [Accepted: 02/28/2021] [Indexed: 06/12/2023]
Abstract
Low-intensity, low-frequency ultrasound (LILFU) has recently emerged as a promising technique to modulate non-invasively nerve activities at lower cost than other traditional and more-invasive neuromodulation methods. However, there is currently no consensus on the optimum sonication parameters to be used in LILFU applications, and most of the accepted ranges have arisen from trial-and-error approaches. Here we utilise a recently proposed micromechanics model of membrane flexoelectricity, a potential candidate for neuromodulation, and simulate action potentials/membrane polarisation triggered by acoustic pulses of different pulse frequencies, pulse magnitudes and duty cycles. Results reveal that, at constant duty cycles, increasing the transmit frequency increases the thresholds of both the pulse magnitude and the elastic energy rate density required to mechanically trigger an action potential, whereas at constant frequencies, increasing the duty cycle reduces both. The influence of transmit frequency is weakened at lower duty cycles. Our simulation results offer some guidance on the selections of sonication parameters used in LILFU for neurologic disorder treatments in the context of the flexoelectricity hypothesis.
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Affiliation(s)
- Haoyu Chen
- Department of Engineering Science, University of Oxford, Oxford, United Kingdom
| | - Antoine Jerusalem
- Department of Engineering Science, University of Oxford, Oxford, United Kingdom.
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57
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Baek H, Yang Y, Pacia CP, Xu L, Yue Y, Bruchas MR, Chen H. Mechanical and mechanothermal effects of focused ultrasound elicited distinct electromyographic responses in mice. Phys Med Biol 2021; 66. [PMID: 34098539 DOI: 10.1088/1361-6560/ac08b1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 06/07/2021] [Indexed: 11/11/2022]
Abstract
The objective of this study was to compare focused ultrasound (FUS) neuromodulation-induced motor responses under two physical mechanisms: mechanical and mechanothermal effects. Mice were divided into two groups. One group was subjected to short-duration FUS stimulation (0.3 s) that induced mechanical effects (mechanical group). The other group underwent long-duration FUS stimulation (15 s) that produced not only mechanical but also thermal effects (mechanothermal group). FUS was targeted at the deep cerebellar nucleus in the cerebellum to induce motor responses, which were evaluated by recording the evoked electromyographic (EMG) signals and tail movements. Brain tissue temperature rise associated with the FUS stimulation was quantified by noninvasive magnetic resonance thermometryin vivo. Temperature rise was negligible for the mechanical group (0.2 °C ± 0.1 °C) but did rise within the range of 0.6 °C ± 0.2 °C-3.3 °C ± 0.9 °C for the mechanothermal group. The elongated FUS beam also induced heating in the dorsal brain (below the top skull) and ventral brain (above the bottom skull) along the beam path for the mechanothermal group. Both mechanical and mechanothermal groups achieved successful FUS neuromodulation. EMG response latencies were within the range of 0.03-0.1 s at different intensity levels for the mechanical group. The mechanothermal effect of FUS could induce both short-latency EMG (0.2-1.4 s) and long-latency EMG (8.7-13.0 s) under the same intensity levels as the mechanical group. The different temporal dynamics of evoked EMG suggested that FUS-induced mechanical and mechanothermal effects could evoke different responses in the brain.
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Affiliation(s)
- Hongchae Baek
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO 63130, United States of America
| | - Yaoheng Yang
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO 63130, United States of America
| | - Christopher Pham Pacia
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO 63130, United States of America
| | - Lu Xu
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO 63130, United States of America
| | - Yimei Yue
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO 63130, United States of America
| | - Michael R Bruchas
- Department of Anesthesiology and Pain Medicine. Center for Neurobiology of Addiction, Pain, and Emotion. University of Washington, Seattle, WA 98195, United States of America
| | - Hong Chen
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO 63130, United States of America.,Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO 63108, United States of America
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Effects of Transcranial Ultrasound Stimulation on Trigeminal Blink Reflex Excitability. Brain Sci 2021; 11:brainsci11050645. [PMID: 34063492 PMCID: PMC8156436 DOI: 10.3390/brainsci11050645] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/05/2021] [Accepted: 05/12/2021] [Indexed: 01/01/2023] Open
Abstract
Recent evidence indicates that transcranial ultrasound stimulation (TUS) modulates sensorimotor cortex excitability. However, no study has assessed possible TUS effects on the excitability of deeper brain areas, such as the brainstem. In this study, we investigated whether TUS delivered on the substantia nigra, superior colliculus, and nucleus raphe magnus modulates the excitability of trigeminal blink reflex, a reliable neurophysiological technique to assess brainstem functions in humans. The recovery cycle of the trigeminal blink reflex (interstimulus intervals of 250 and 500 ms) was tested before (T0), and 3 (T1) and 30 min (T2) after TUS. The effects of substantia nigra-TUS, superior colliculus-TUS, nucleus raphe magnus-TUS and sham-TUS were assessed in separate and randomized sessions. In the superior colliculus-TUS session, the conditioned R2 area increased at T1 compared with T0, while T2 and T0 values did not differ. Results were independent of the interstimulus intervals tested and were not related to trigeminal blink reflex baseline (T0) excitability. Conversely, the conditioned R2 area was comparable at T0, T1, and T2 in the nucleus raphe magnus-TUS and substantia nigra-TUS sessions. Our findings demonstrate that the excitability of brainstem circuits, as evaluated by testing the recovery cycle of the trigeminal blink reflex, can be increased by TUS. This result may reflect the modulation of inhibitory interneurons within the superior colliculus.
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Yu K, Niu X, Krook-Magnuson E, He B. Intrinsic functional neuron-type selectivity of transcranial focused ultrasound neuromodulation. Nat Commun 2021; 12:2519. [PMID: 33947867 PMCID: PMC8097024 DOI: 10.1038/s41467-021-22743-7] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 03/25/2021] [Indexed: 12/11/2022] Open
Abstract
Transcranial focused ultrasound (tFUS) is a promising neuromodulation technique, but its mechanisms remain unclear. We hypothesize that if tFUS parameters exhibit distinct modulation effects in different neuron populations, then the mechanism can be understood through identifying unique features in these neuron populations. In this work, we investigate the effect of tFUS stimulation on different functional neuron types in in vivo anesthetized rodent brains. Single neuron recordings were separated into regular-spiking and fast-spiking units based on their extracellular spike shapes acquired through intracranial electrophysiological recordings, and further validated in transgenic optogenetic mice models of light-excitable excitatory and inhibitory neurons. We show that excitatory and inhibitory neurons are intrinsically different in response to ultrasound pulse repetition frequency (PRF). The results suggest that we can preferentially target specific neuron types noninvasively by tuning the tFUS PRF. Chemically deafened rats and genetically deafened mice were further tested for validating the directly local neural effects induced by tFUS without potential auditory confounds.
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Affiliation(s)
- Kai Yu
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Xiaodan Niu
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
| | | | - Bin He
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA.
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Real time and delayed effects of subcortical low intensity focused ultrasound. Sci Rep 2021; 11:6100. [PMID: 33731821 PMCID: PMC7969624 DOI: 10.1038/s41598-021-85504-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 03/01/2021] [Indexed: 02/08/2023] Open
Abstract
Deep brain nuclei are integral components of large-scale circuits mediating important cognitive and sensorimotor functions. However, because they fall outside the domain of conventional non-invasive neuromodulatory techniques, their study has been primarily based on neuropsychological models, limiting the ability to fully characterize their role and to develop interventions in cases where they are damaged. To address this gap, we used the emerging technology of non-invasive low-intensity focused ultrasound (LIFU) to directly modulate left lateralized basal ganglia structures in healthy volunteers. During sonication, we observed local and distal decreases in blood oxygenation level dependent (BOLD) signal in the targeted left globus pallidus (GP) and in large-scale cortical networks. We also observed a generalized decrease in relative perfusion throughout the cerebrum following sonication. These results show, for the first time using functional MRI data, the ability to modulate deep-brain nuclei using LIFU while measuring its local and global consequences, opening the door for future applications of subcortical LIFU.
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Pérez-Neri I, González-Aguilar A, Sandoval H, Pineda C, Ríos C. Therapeutic Potential of Ultrasound Neuromodulation in Decreasing Neuropathic Pain: Clinical and Experimental Evidence. Curr Neuropharmacol 2021; 19:334-348. [PMID: 32691714 PMCID: PMC8033967 DOI: 10.2174/1570159x18666200720175253] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/23/2020] [Accepted: 07/07/2020] [Indexed: 01/01/2023] Open
Abstract
Background For more than seven decades, ultrasound has been used as an imaging and diagnostic tool. Today, new technologies, such as focused ultrasound (FUS) neuromodulation, have revealed some innovative, potential applications. However, those applications have been barely studied to deal with neuropathic pain (NP), a cluster of chronic pain syndromes with a restricted response to conventional pharmaceuticals. Objective To analyze the therapeutic potential of low-intensity (LIFUS) and high-intensity (HIFUS) FUS for managing NP. Methods We performed a narrative review, including clinical and experimental ultrasound neuromodulation studies published in three main database repositories. Discussion Evidence shows that FUS may influence several mechanisms relevant for neuropathic pain management such as modulation of ion channels, glutamatergic neurotransmission, cerebral blood flow, inflammation and neurotoxicity, neuronal morphology and survival, nerve regeneration, and remyelination. Some experimental models have shown that LIFUS may reduce allodynia after peripheral nerve damage. At the same time, a few clinical studies support its beneficial effect on reducing pain in nerve compression syndromes. In turn, Thalamic HIFUS ablation can reduce NP from several etiologies with minor side-effects, but some neurological sequelae might be permanent. HIFUS is also useful in lowering non-neuropathic pain in several disorders. Conclusion Although an emerging set of studies brings new evidence on the therapeutic potential of both LIFUS and HIFUS for managing NP with minor side-effects, we need more controlled clinical trials to conclude about its safety and efficacy.
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Affiliation(s)
- Iván Pérez-Neri
- Department of Neurochemistry, National Institute of Neurology and Neurosurgery, Insurgentes Sur 3877, La Fama, Tlalpan, Mexico City, 14269, Mexico
| | - Alberto González-Aguilar
- Neuro-oncology Unit, Instituto Nacional de Neurología y Neurocirugia Manuel Velasco Suarez, Insurgentes Sur 3877, La Fama, Tlalpan, Mexico City, 14269, Mexico
| | - Hugo Sandoval
- Sociomedical Research Unit, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Calzada México-Xochimilco 289, Col, Arenal de Guadalupe, Alcaldia Tlalpan, C.P. 14389, Mexico City, Mexico
| | - Carlos Pineda
- Division of Musculoskeletal and Rheumatic Disorders, Instituto Nacional de Rehabilitacion Luis Guillermo Ibarra Ibarra, Calzada Mexico-Xochimilco 289, Col, Arenal de Guadalupe, Alcaldia Tlalpan, C.P.14389, Mexico City, Mexico
| | - Camilo Ríos
- Department of Neurochemistry, National Institute of Neurology and Neurosurgery, Insurgentes Sur 3877, La Fama, Tlalpan, Mexico City, 14269, Mexico
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Huerta TS, Devarajan A, Tsaava T, Rishi A, Cotero V, Puleo C, Ashe J, Coleman TR, Chang EH, Tracey KJ, Chavan SS. Targeted peripheral focused ultrasound stimulation attenuates obesity-induced metabolic and inflammatory dysfunctions. Sci Rep 2021; 11:5083. [PMID: 33658532 PMCID: PMC7930257 DOI: 10.1038/s41598-021-84330-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/05/2021] [Indexed: 02/06/2023] Open
Abstract
Obesity, a growing health concern, is associated with an increased risk of morbidity and mortality. Chronic low-grade inflammation is implicated in obesity-driven metabolic complications. Peripheral focused ultrasound stimulation (pFUS) is an emerging non-invasive technology that modulates inflammation. Here, we reasoned that focused ultrasound stimulation of the liver may alleviate obesity-related inflammation and other comorbidities. After 8 weeks on a high-fat high-carbohydrate "Western" diet, C57BL/6J mice were subjected to either sham stimulation or focused ultrasound stimulation at the porta hepatis. Daily liver-focused ultrasound stimulation for 8 weeks significantly decreased body weight, circulating lipids and mitigated dysregulation of adipokines. In addition, liver-focused ultrasound stimulation significantly reduced hepatic cytokine levels and leukocyte infiltration. Our findings demonstrate the efficacy of hepatic focused ultrasound for alleviating obesity and obesity-associated complications in mice. These findings suggest a previously unrecognized potential of hepatic focused ultrasound as a possible novel noninvasive approach in the context of obesity.
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Affiliation(s)
- Tomás S Huerta
- Institute of Bioelectronic Medicine, The Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY, 11549, USA
| | - Alex Devarajan
- Institute of Bioelectronic Medicine, The Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA
| | - Tea Tsaava
- Institute of Bioelectronic Medicine, The Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA
| | - Arvind Rishi
- Department of Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | | | | | - Jeffrey Ashe
- GE Research, 1 Research Circle, Niskayuna, NY, 12309, USA
| | - Thomas R Coleman
- Institute of Bioelectronic Medicine, The Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA
| | - Eric H Chang
- Institute of Bioelectronic Medicine, The Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY, 11549, USA
| | - Kevin J Tracey
- Institute of Bioelectronic Medicine, The Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA.
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY, 11549, USA.
- The Elmezzi Graduate School of Molecular Medicine, 350 Community Drive, Manhasset, NY, 11030, USA.
| | - Sangeeta S Chavan
- Institute of Bioelectronic Medicine, The Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA.
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY, 11549, USA.
- The Elmezzi Graduate School of Molecular Medicine, 350 Community Drive, Manhasset, NY, 11030, USA.
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63
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Wang J, Li G, Deng L, Mamtilahun M, Jiang L, Qiu W, Zheng H, Sun J, Xie Q, Yang GY. Transcranial Focused Ultrasound Stimulation Improves Neurorehabilitation after Middle Cerebral Artery Occlusion in Mice. Aging Dis 2021; 12:50-60. [PMID: 33532127 PMCID: PMC7801287 DOI: 10.14336/ad.2020.0623] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 06/23/2020] [Indexed: 12/27/2022] Open
Abstract
Transcranial focused ultrasound stimulation (tFUS) regulates neural activity in different brain regions in humans and animals. However, the role of ultrasound stimulation in modulating neural activity and promoting neurorehabilitation in the ischemic brain is largely unknown. In the present study, we explored the effect of tFUS on neurological rehabilitation and the underlying mechanism. Adult male ICR mice (n=42) underwent transient middle cerebral artery occlusion. One week after brain ischemia, low frequency (0.5 MHz) tFUS was applied to stimulate the ischemic hemisphere of mice for 7 consecutive days (10 minutes daily). Brain infarct volume, neurobehavioral tests, microglia activation, IL-10 and IL-10R levels were further assessed for up to 14 days. We found that the brain infarct volume was significantly reduced in the tFUS treated mice compared to that in the non-treated mice (p<0.05). Similarly, neurological severity scores, elevated body swing test, and corner test improved in the tFUS treated mice (p<0.05). We also demonstrated that tFUS resulted in increased M2 microglia in the ischemic brain region. The expression of IL-10R and IL-10 levels were also substantially upregulated (p<0.05). We concluded that tFUS served as a unique technique to promote neurorehabilitation after brain ischemia by promoting microglia polarization and further regulating IL-10 signaling in the ischemic brain.
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Affiliation(s)
- Jixian Wang
- 1Department of Rehabilitation, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Guofeng Li
- 3Shenzhen Institutes of Advanced Technology Chinese Academy of Sciences, Shenzhen 518055, China.,4School of Information Engineering, Guangdong Medical University, Dongguan 523808, China
| | - Lidong Deng
- 2Med-X Research Institute and School of Biomedical Engineering, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Muyassar Mamtilahun
- 2Med-X Research Institute and School of Biomedical Engineering, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Lu Jiang
- 2Med-X Research Institute and School of Biomedical Engineering, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Weibao Qiu
- 3Shenzhen Institutes of Advanced Technology Chinese Academy of Sciences, Shenzhen 518055, China
| | - Hairong Zheng
- 3Shenzhen Institutes of Advanced Technology Chinese Academy of Sciences, Shenzhen 518055, China
| | - Junfeng Sun
- 2Med-X Research Institute and School of Biomedical Engineering, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Qing Xie
- 1Department of Rehabilitation, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Guo-Yuan Yang
- 2Med-X Research Institute and School of Biomedical Engineering, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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64
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Sanches C, Stengel C, Godard J, Mertz J, Teichmann M, Migliaccio R, Valero-Cabré A. Past, Present, and Future of Non-invasive Brain Stimulation Approaches to Treat Cognitive Impairment in Neurodegenerative Diseases: Time for a Comprehensive Critical Review. Front Aging Neurosci 2021; 12:578339. [PMID: 33551785 PMCID: PMC7854576 DOI: 10.3389/fnagi.2020.578339] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/07/2020] [Indexed: 12/14/2022] Open
Abstract
Low birth rates and increasing life expectancy experienced by developed societies have placed an unprecedented pressure on governments and the health system to deal effectively with the human, social and financial burden associated to aging-related diseases. At present, ∼24 million people worldwide suffer from cognitive neurodegenerative diseases, a prevalence that doubles every five years. Pharmacological therapies and cognitive training/rehabilitation have generated temporary hope and, occasionally, proof of mild relief. Nonetheless, these approaches are yet to demonstrate a meaningful therapeutic impact and changes in prognosis. We here review evidence gathered for nearly a decade on non-invasive brain stimulation (NIBS), a less known therapeutic strategy aiming to limit cognitive decline associated with neurodegenerative conditions. Transcranial Magnetic Stimulation and Transcranial Direct Current Stimulation, two of the most popular NIBS technologies, use electrical fields generated non-invasively in the brain to long-lastingly enhance the excitability/activity of key brain regions contributing to relevant cognitive processes. The current comprehensive critical review presents proof-of-concept evidence and meaningful cognitive outcomes of NIBS in eight of the most prevalent neurodegenerative pathologies affecting cognition: Alzheimer's Disease, Parkinson's Disease, Dementia with Lewy Bodies, Primary Progressive Aphasias (PPA), behavioral variant of Frontotemporal Dementia, Corticobasal Syndrome, Progressive Supranuclear Palsy, and Posterior Cortical Atrophy. We analyzed a total of 70 internationally published studies: 33 focusing on Alzheimer's disease, 19 on PPA and 18 on the remaining neurodegenerative pathologies. The therapeutic benefit and clinical significance of NIBS remains inconclusive, in particular given the lack of a sufficient number of double-blind placebo-controlled randomized clinical trials using multiday stimulation regimes, the heterogeneity of the protocols, and adequate behavioral and neuroimaging response biomarkers, able to show lasting effects and an impact on prognosis. The field remains promising but, to make further progress, research efforts need to take in account the latest evidence of the anatomical and neurophysiological features underlying cognitive deficits in these patient populations. Moreover, as the development of in vivo biomarkers are ongoing, allowing for an early diagnosis of these neuro-cognitive conditions, one could consider a scenario in which NIBS treatment will be personalized and made part of a cognitive rehabilitation program, or useful as a potential adjunct to drug therapies since the earliest stages of suh diseases. Research should also integrate novel knowledge on the mechanisms and constraints guiding the impact of electrical and magnetic fields on cerebral tissues and brain activity, and incorporate the principles of information-based neurostimulation.
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Affiliation(s)
- Clara Sanches
- Cerebral Dynamics, Plasticity and Rehabilitation Group, FRONTLAB Team, CNRS UMR 7225, INSERM U 1127, Institut du Cerveau, Sorbonne Universités, Paris, France
| | - Chloé Stengel
- Cerebral Dynamics, Plasticity and Rehabilitation Group, FRONTLAB Team, CNRS UMR 7225, INSERM U 1127, Institut du Cerveau, Sorbonne Universités, Paris, France
| | - Juliette Godard
- Cerebral Dynamics, Plasticity and Rehabilitation Group, FRONTLAB Team, CNRS UMR 7225, INSERM U 1127, Institut du Cerveau, Sorbonne Universités, Paris, France
| | - Justine Mertz
- Cerebral Dynamics, Plasticity and Rehabilitation Group, FRONTLAB Team, CNRS UMR 7225, INSERM U 1127, Institut du Cerveau, Sorbonne Universités, Paris, France
| | - Marc Teichmann
- Cerebral Dynamics, Plasticity and Rehabilitation Group, FRONTLAB Team, CNRS UMR 7225, INSERM U 1127, Institut du Cerveau, Sorbonne Universités, Paris, France.,National Reference Center for Rare or Early Onset Dementias, Department of Neurology, Institute of Memory and Alzheimer's Disease, Pitié-Salpêtrière Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France
| | - Raffaella Migliaccio
- Cerebral Dynamics, Plasticity and Rehabilitation Group, FRONTLAB Team, CNRS UMR 7225, INSERM U 1127, Institut du Cerveau, Sorbonne Universités, Paris, France.,National Reference Center for Rare or Early Onset Dementias, Department of Neurology, Institute of Memory and Alzheimer's Disease, Pitié-Salpêtrière Hospital, Assistance Publique -Hôpitaux de Paris, Paris, France
| | - Antoni Valero-Cabré
- Cerebral Dynamics, Plasticity and Rehabilitation Group, FRONTLAB Team, CNRS UMR 7225, INSERM U 1127, Institut du Cerveau, Sorbonne Universités, Paris, France.,Laboratory for Cerebral Dynamics Plasticity & Rehabilitation, Boston University School of Medicine, Boston, MA, United States.,Cognitive Neuroscience and Information Technology Research Program, Open University of Catalonia, Barcelona, Spain
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65
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Giammalva GR, Gagliardo C, Marrone S, Paolini F, Gerardi RM, Umana GE, Yağmurlu K, Chaurasia B, Scalia G, Midiri F, La Grutta L, Basile L, Gulì C, Messina D, Pino MA, Graziano F, Tumbiolo S, Iacopino DG, Maugeri R. Focused Ultrasound in Neuroscience. State of the Art and Future Perspectives. Brain Sci 2021; 11:84. [PMID: 33435152 PMCID: PMC7827488 DOI: 10.3390/brainsci11010084] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 12/14/2022] Open
Abstract
Transcranial MR-guided Focused ultrasound (tcMRgFUS) is a surgical procedure that adopts focused ultrasounds beam towards a specific therapeutic target through the intact skull. The convergence of focused ultrasound beams onto the target produces tissue effects through released energy. Regarding neurosurgical applications, tcMRgFUS has been successfully adopted as a non-invasive procedure for ablative purposes such as thalamotomy, pallidotomy, and subthalamotomy for movement disorders. Several studies confirmed the effectiveness of tcMRgFUS in the treatment of several neurological conditions, ranging from motor disorders to psychiatric disorders. Moreover, using low-frequencies tcMRgFUS systems temporarily disrupts the blood-brain barrier, making this procedure suitable in neuro-oncology and neurodegenerative disease for controlled drug delivery. Nowadays, tcMRgFUS represents one of the most promising and fascinating technologies in neuroscience. Since it is an emerging technology, tcMRgFUS is still the subject of countless disparate studies, even if its effectiveness has been already proven in many experimental and therapeutic fields. Therefore, although many studies have been carried out, many others are still needed to increase the degree of knowledge of the innumerable potentials of tcMRgFUS and thus expand the future fields of application of this technology.
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Affiliation(s)
- Giuseppe Roberto Giammalva
- Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.R.G.); (S.M.); (F.P.); (R.M.G.); (L.B.); (C.G.); (D.M.); (M.A.P.); (D.G.I.); (R.M.)
| | - Cesare Gagliardo
- Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (C.G.); (F.M.)
| | - Salvatore Marrone
- Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.R.G.); (S.M.); (F.P.); (R.M.G.); (L.B.); (C.G.); (D.M.); (M.A.P.); (D.G.I.); (R.M.)
| | - Federica Paolini
- Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.R.G.); (S.M.); (F.P.); (R.M.G.); (L.B.); (C.G.); (D.M.); (M.A.P.); (D.G.I.); (R.M.)
| | - Rosa Maria Gerardi
- Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.R.G.); (S.M.); (F.P.); (R.M.G.); (L.B.); (C.G.); (D.M.); (M.A.P.); (D.G.I.); (R.M.)
| | | | - Kaan Yağmurlu
- Departments of Neuroscience and Neurosurgery, University of Virginia Health System, Charlottesville, VA 22903, USA;
| | - Bipin Chaurasia
- Department of Neurosurgery, Neurosurgery Clinic, Birgunj 44300, Nepal;
| | - Gianluca Scalia
- Department of Neurosurgery, Highly Specialized Hospital of National Importance “Garibaldi”, 95122 Catania, Italy; (G.S.); (F.G.)
| | - Federico Midiri
- Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (C.G.); (F.M.)
| | - Ludovico La Grutta
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties-ProMISE, University of Palermo, 90127 Palermo, Italy;
| | - Luigi Basile
- Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.R.G.); (S.M.); (F.P.); (R.M.G.); (L.B.); (C.G.); (D.M.); (M.A.P.); (D.G.I.); (R.M.)
| | - Carlo Gulì
- Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.R.G.); (S.M.); (F.P.); (R.M.G.); (L.B.); (C.G.); (D.M.); (M.A.P.); (D.G.I.); (R.M.)
| | - Domenico Messina
- Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.R.G.); (S.M.); (F.P.); (R.M.G.); (L.B.); (C.G.); (D.M.); (M.A.P.); (D.G.I.); (R.M.)
| | - Maria Angela Pino
- Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.R.G.); (S.M.); (F.P.); (R.M.G.); (L.B.); (C.G.); (D.M.); (M.A.P.); (D.G.I.); (R.M.)
| | - Francesca Graziano
- Department of Neurosurgery, Highly Specialized Hospital of National Importance “Garibaldi”, 95122 Catania, Italy; (G.S.); (F.G.)
| | - Silvana Tumbiolo
- Division of Neurosurgery, Villa Sofia Hospital, 90146 Palermo, Italy;
| | - Domenico Gerardo Iacopino
- Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.R.G.); (S.M.); (F.P.); (R.M.G.); (L.B.); (C.G.); (D.M.); (M.A.P.); (D.G.I.); (R.M.)
| | - Rosario Maugeri
- Neurosurgery Unit, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.R.G.); (S.M.); (F.P.); (R.M.G.); (L.B.); (C.G.); (D.M.); (M.A.P.); (D.G.I.); (R.M.)
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66
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Choi EH, Nwakalor C, Brown NJ, Lee J, Oh MY, Yang IH. Therapeutic potential of neuromodulation for demyelinating diseases. Neural Regen Res 2021; 16:214-217. [PMID: 32859766 PMCID: PMC7896214 DOI: 10.4103/1673-5374.290876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Neuromodulation represents a cutting edge class of both invasive and non-invasive therapeutic methods which alter the activity of neurons. Currently, several different techniques have been developed - or are currently being investigated – to treat a wide variety of neurological and neuropsychiatric disorders. Recently, in vivo and in vitro studies have revealed that neuromodulation can also induce myelination, meaning that it could hold potential as a therapy for various demyelinating diseases including multiple sclerosis and progressive multifocal leukencepalopathy. These findings come on the heels of a paradigm shift in the view of myelin’s role within the nervous system from a static structure to an active co-regulator of central nervous system plasticity and participant in neuron-mediated modulation. In the present review, we highlight several of the recent findings regarding the role of neural activity in altering myelination including several soluble and contact-dependent factors that seem to mediate neural activity-dependent myelination. We also highlight several considerations for neuromodulatory techniques, including the need for further research into spatiotemporal precision, dosage, and the safety and efficacy of transcranial focused ultrasound stimulation, an emerging neuromodulation technology. As the field of neuromodulation continues to evolve, it could potentially bring forth methods for the treatment of demyelinating diseases, and as such, further investigation into the mechanisms of neuron-dependent myelination as well as neuro-imaging modalities that can monitor myelination activity is warranted.
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Affiliation(s)
- Elliot H Choi
- Department of Pharmacology, School of Medicine, Case Western Reserve University, Cleveland, OH; Department of Ophthalmology, Gavin Herbert Eye Institute, School of Medicine, University of California; Department of Neurological Surgery, University of California, Irvine, CA, USA
| | - Chioma Nwakalor
- Department of Mechanical Engineering and Engineering Science, Center for Biomedical Engineering and Science, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Nolan J Brown
- Department of Neurological Surgery, University of California, Irvine, CA, USA
| | - Joonho Lee
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Michael Y Oh
- Department of Neurological Surgery, University of California, Irvine, CA, USA
| | - In Hong Yang
- Department of Mechanical Engineering and Engineering Science, Center for Biomedical Engineering and Science, University of North Carolina at Charlotte, Charlotte, NC, USA
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67
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Choi SW, Gerhardson TI, Duclos SE, Surowiec RK, Scheven UM, Galban S, Lee FT, Greve JM, Balter JM, Hall TL, Xu Z. Stereotactic Transcranial Focused Ultrasound Targeting System for Murine Brain Models. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:154-163. [PMID: 32746229 PMCID: PMC7814337 DOI: 10.1109/tuffc.2020.3012303] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
An inexpensive, accurate focused ultrasound stereotactic targeting method guided by pretreatment magnetic resonance imaging (MRI) images for murine brain models is presented. An uncertainty of each sub-component of the stereotactic system was analyzed. The entire system was calibrated using clot phantoms. The targeting accuracy of the system was demonstrated with an in vivo mouse glioblastoma (GBM) model. The accuracy was quantified by the absolute distance difference between the prescribed and ablated points visible on the pre treatment and posttreatment MR images, respectively. A precalibration phantom study ( N = 6 ) resulted in an error of 0.32 ± 0.31, 0.72 ± 0.16, and 1.06 ± 0.38 mm in axial, lateral, and elevational axes, respectively. A postcalibration phantom study ( N = 8 ) demonstrated a residual error of 0.09 ± 0.01, 0.15 ± 0.09, and 0.47 ± 0.18 mm in axial, lateral, and elevational axes, respectively. The calibrated system showed significantly reduced ( ) error of 0.20 ± 0.21, 0.34 ± 0.24, and 0.28 ± 0.21 mm in axial, lateral, and elevational axes, respectively, in the in vivo GBM tumor-bearing mice ( N = 10 ).
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68
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Lu G, Qian X, Castillo J, Li R, Jiang L, Lu H, Kirk Shung K, Humayun MS, Thomas BB, Zhou Q. Transcranial Focused Ultrasound for Noninvasive Neuromodulation of the Visual Cortex. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:21-28. [PMID: 32746196 PMCID: PMC8153235 DOI: 10.1109/tuffc.2020.3005670] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Currently, blindness cannot be cured and patients' living quality can be compromised severely. Ultrasonic (US) neuromodulation is a promising technology for the development of noninvasive cortical visual prosthesis. We investigated the feasibility of transcranial focused ultrasound (tFUS) for noninvasive stimulation of the visual cortex (VC) to develop improved visual prosthesis. tFUS was used to successfully evoke neural activities in the VC of both normal and retinal degenerate (RD) blind rats. Our results showed that blind rats showed more robust responses to ultrasound stimulation when compared with normal rats. ( , two-sample t-test). Three different types of ultrasound waveforms were used in the three experimental groups. Different types of cortical activities were observed when different US waveforms were used. In all rats, when stimulated with continuous ultrasound waves, only short-duration responses were observed at "US on and off" time points. In comparison, pulsed waves (PWs) evoked longer low-frequency responses. Testing different parameters of PWs showed that a pulse repetition frequency higher than 100 Hz is required to obtain the low-frequency responses. Based on the observed cortical activities, we inferred that acoustic radiation force (ARF) is the predominant physical mechanism of ultrasound neuromodulation.
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69
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Cho Y, Park J, Lee C, Lee S. Recent progress on peripheral neural interface technology towards bioelectronic medicine. Bioelectron Med 2020; 6:23. [PMID: 33292861 PMCID: PMC7706233 DOI: 10.1186/s42234-020-00059-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 11/05/2020] [Indexed: 11/23/2022] Open
Abstract
Modulation of the peripheral nervous system (PNS) has a great potential for therapeutic intervention as well as restore bodily functions. Recent interest has focused on autonomic nerves, as they regulate extensive functions implicated in organ physiology, chronic disease state and appear tractable to targeted modulation of discrete nerve units. Therapeutic interventions based on specific bioelectronic neuromodulation depend on reliable neural interface to stimulate and record autonomic nerves. Furthermore, the function of stimulation and recording requires energy which should be delivered to the interface. Due to the physiological and anatomical challenges of autonomic nerves, various forms of this active neural interface need to be developed to achieve next generation of neural interface for bioelectronic medicine. In this article, we present an overview of the state-of-the-art for peripheral neural interface technology in relation to autonomic nerves. Also, we reveal the current status of wireless neural interface for peripheral nerve applications. Recent studies of a novel concept of self-sustainable neural interface without battery and electronic components are presented. Finally, the recent results of non-invasive stimulation such as ultrasound and magnetic stimulation are covered and the perspective of the future research direction is provided.
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Affiliation(s)
- Youngjun Cho
- Daegu Geongbuk Institute of Science and Technology (DGIST), Daegu, 42899, Republic of Korea
| | - Jaeu Park
- Daegu Geongbuk Institute of Science and Technology (DGIST), Daegu, 42899, Republic of Korea
| | - Chengkuo Lee
- Electrical & Computer Engineering, National University of Singapore, Singapore, 117583, Singapore. .,Center for Intelligent Sensors and MEMS (CISM), National University of Singapore, Singapore, 117608, Singapore. .,NUS Graduate School for Integrated Science and Engineering (NGS), National University of Singapore, Singapore, 117456, Singapore.
| | - Sanghoon Lee
- Daegu Geongbuk Institute of Science and Technology (DGIST), Daegu, 42899, Republic of Korea.
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70
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Ozdas MS, Shah AS, Johnson PM, Patel N, Marks M, Yasar TB, Stalder U, Bigler L, von der Behrens W, Sirsi SR, Yanik MF. Non-invasive molecularly-specific millimeter-resolution manipulation of brain circuits by ultrasound-mediated aggregation and uncaging of drug carriers. Nat Commun 2020; 11:4929. [PMID: 33004789 PMCID: PMC7529901 DOI: 10.1038/s41467-020-18059-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 07/31/2020] [Indexed: 12/13/2022] Open
Abstract
Non-invasive, molecularly-specific, focal modulation of brain circuits with low off-target effects can lead to breakthroughs in treatments of brain disorders. We systemically inject engineered ultrasound-controllable drug carriers and subsequently apply a novel two-component Aggregation and Uncaging Focused Ultrasound Sequence (AU-FUS) at the desired targets inside the brain. The first sequence aggregates drug carriers with millimeter-precision by orders of magnitude. The second sequence uncages the carrier's cargo locally to achieve high target specificity without compromising the blood-brain barrier (BBB). Upon release from the carriers, drugs locally cross the intact BBB. We show circuit-specific manipulation of sensory signaling in motor cortex in rats by locally concentrating and releasing a GABAA receptor agonist from ultrasound-controlled carriers. Our approach uses orders of magnitude (1300x) less drug than is otherwise required by systemic injection and requires very low ultrasound pressures (20-fold below FDA safety limits for diagnostic imaging). We show that the BBB remains intact using passive cavitation detection (PCD), MRI-contrast agents and, importantly, also by sensitive fluorescent dye extravasation and immunohistochemistry.
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Affiliation(s)
- Mehmet S Ozdas
- Institute of Neuroinformatics, D-ITET, ETH Zurich and UZH, Zurich, Switzerland.,Neuroscience Center, Zurich, Switzerland
| | - Aagam S Shah
- Institute of Neuroinformatics, D-ITET, ETH Zurich and UZH, Zurich, Switzerland. .,Neuroscience Center, Zurich, Switzerland.
| | - Paul M Johnson
- Institute of Neuroinformatics, D-ITET, ETH Zurich and UZH, Zurich, Switzerland.,Neuroscience Center, Zurich, Switzerland
| | - Nisheet Patel
- Institute of Neuroinformatics, D-ITET, ETH Zurich and UZH, Zurich, Switzerland
| | - Markus Marks
- Institute of Neuroinformatics, D-ITET, ETH Zurich and UZH, Zurich, Switzerland.,Neuroscience Center, Zurich, Switzerland
| | - Tansel Baran Yasar
- Institute of Neuroinformatics, D-ITET, ETH Zurich and UZH, Zurich, Switzerland.,Neuroscience Center, Zurich, Switzerland
| | - Urs Stalder
- Department of Chemistry, UZH, Zurich, Switzerland
| | | | - Wolfger von der Behrens
- Institute of Neuroinformatics, D-ITET, ETH Zurich and UZH, Zurich, Switzerland.,Neuroscience Center, Zurich, Switzerland
| | - Shashank R Sirsi
- Institute of Neuroinformatics, D-ITET, ETH Zurich and UZH, Zurich, Switzerland.,Department of Bioengineering, UT at Dallas, Richardson, USA
| | - Mehmet Fatih Yanik
- Institute of Neuroinformatics, D-ITET, ETH Zurich and UZH, Zurich, Switzerland. .,Neuroscience Center, Zurich, Switzerland.
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71
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Todd N, McDannold N, Borsook D. Targeted manipulation of pain neural networks: The potential of focused ultrasound for treatment of chronic pain. Neurosci Biobehav Rev 2020; 115:238-250. [PMID: 32534900 PMCID: PMC7483565 DOI: 10.1016/j.neubiorev.2020.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/24/2020] [Accepted: 06/04/2020] [Indexed: 12/29/2022]
Abstract
Focused ultrasound (FUS) is a promising technology for facilitating treatment of brain diseases including chronic pain. Focused ultrasound is a unique modality for delivering therapeutic levels of energy into the body, including the central nervous system (CNS). It is non-invasive and can target spatially localized effects through the intact skull to cortical or subcortical regions of the brain. FUS can achieve three different mechanisms of action in the brain that are relevant for chronic pain treatment: (1) localized thermal ablation of neural tissue; (2) localized and transient disruption of the blood-brain barrier for targeted drug delivery to CNS structures; and (3) inhibition or stimulation of neuronal activity in targeted regions. This review provides an in-depth look at the technology of FUS with emphasis placed on applications to CNS-based treatments of chronic pain. While still in the early stages of clinical translation and with some technical challenges remaining, we suggest that FUS has great potential as a novel approach for manipulating CNS networks involved in pain treatment.
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Affiliation(s)
- Nick Todd
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Center for Pain and the Brain, 1 Autumn Street, Boston Children's Hospital, Boston, MA, 02115, United States.
| | - Nathan McDannold
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - David Borsook
- Center for Pain and the Brain, 1 Autumn Street, Boston Children's Hospital, Boston, MA, 02115, United States; Department of Anesthesia, Perioperative, and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, 02115, United States
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72
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Gu J, Jing Y. A modified mixed domain method for modeling acoustic wave propagation in strongly heterogeneous media. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2020; 147:4055. [PMID: 32611145 PMCID: PMC7311178 DOI: 10.1121/10.0001454] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 05/17/2020] [Accepted: 06/03/2020] [Indexed: 05/23/2023]
Abstract
In this paper, phase correction and amplitude compensation are introduced to a previously developed mixed domain method (MDM), which is only accurate for modeling wave propagation in weakly heterogeneous media. Multiple reflections are also incorporated with the one-way model to improve the accuracy. The resulting model is denoted as the modified mixed domain method (MMDM) and is numerically evaluated for its accuracy and efficiency using four distinct cases. It is found that the MMDM is significantly more accurate than the MDM for strongly heterogeneous media, especially when the phase aberrating layer is approximately perpendicular to the acoustic beam. Additionally, a convergence study suggests that the second-order reflection could be sufficient for cases involving high contrast inhomogeneities and large loss values (e.g., skulls). The method developed in this work could facilitate therapeutic ultrasound for treating brain-related diseases and disorders.
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Affiliation(s)
- Juanjuan Gu
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina 27695, USA
| | - Yun Jing
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina 27695, USA
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73
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Rich MC, Sherwood J, Bartley AF, Whitsitt QA, Lee M, Willoughby WR, Dobrunz LE, Bao Y, Lubin FD, Bolding M. Focused ultrasound blood brain barrier opening mediated delivery of MRI-visible albumin nanoclusters to the rat brain for localized drug delivery with temporal control. J Control Release 2020; 324:172-180. [PMID: 32376461 DOI: 10.1016/j.jconrel.2020.04.054] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/22/2020] [Accepted: 04/30/2020] [Indexed: 12/11/2022]
Abstract
There is an ongoing need for noninvasive tools to manipulate brain activity with molecular, spatial and temporal specificity. Here we have investigated the use of MRI-visible, albumin-based nanoclusters for noninvasive, localized and temporally specific drug delivery to the rat brain. We demonstrated that IV injected nanoclusters could be deposited into target brain regions via focused ultrasound facilitated blood brain barrier opening. We showed that nanocluster location could be confirmed in vivo with MRI. Additionally, following confirmation of nanocluster delivery, release of the nanocluster payload into brain tissue can be triggered by a second focused ultrasound treatment performed without circulating microbubbles. Release of glutamate from nanoclusters in vivo caused enhanced c-Fos expression, indicating that the loading capacity of the nanoclusters is sufficient to induce neuronal activation. This novel technique for noninvasive stereotactic drug delivery to the brain with temporal specificity could provide a new way to study brain circuits in vivo preclinically with high relevance for clinical translation.
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Affiliation(s)
- Megan C Rich
- Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
| | - Jennifer Sherwood
- Department of Chemical and Biological Engineering, University of Alabama at Tuscaloosa, Tuscaloosa, AL 35487, USA
| | - Aundrea F Bartley
- Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
| | - Quentin A Whitsitt
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Magdelene Lee
- Department of Chemical and Biological Engineering, University of Alabama at Tuscaloosa, Tuscaloosa, AL 35487, USA
| | - W R Willoughby
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
| | - Lynn E Dobrunz
- Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
| | - Yuping Bao
- Department of Chemical and Biological Engineering, University of Alabama at Tuscaloosa, Tuscaloosa, AL 35487, USA.
| | - Farah D Lubin
- Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
| | - Mark Bolding
- Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA; Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
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74
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Kubanek J, Brown J, Ye P, Pauly KB, Moore T, Newsome W. Remote, brain region-specific control of choice behavior with ultrasonic waves. SCIENCE ADVANCES 2020; 6:eaaz4193. [PMID: 32671207 PMCID: PMC7314556 DOI: 10.1126/sciadv.aaz4193] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 03/09/2020] [Indexed: 05/05/2023]
Abstract
The ability to modulate neural activity in specific brain circuits remotely and systematically could revolutionize studies of brain function and treatments of brain disorders. Sound waves of high frequencies (ultrasound) have shown promise in this respect, combining the ability to modulate neuronal activity with sharp spatial focus. Here, we show that the approach can have potent effects on choice behavior. Brief, low-intensity ultrasound pulses delivered noninvasively into specific brain regions of macaque monkeys influenced their decisions regarding which target to choose. The effects were substantial, leading to around a 2:1 bias in choices compared to the default balanced proportion. The effect presence and polarity was controlled by the specific target region. These results represent a critical step towards the ability to influence choice behavior noninvasively, enabling systematic investigations and treatments of brain circuits underlying disorders of choice.
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Affiliation(s)
- Jan Kubanek
- Department of Biomedical Engineering, University of Utah, 36 S Wasatch Dr, Salt Lake City, UT 84112, USA
| | - Julian Brown
- Department of Neurobiology, Stanford University, 318 Campus Dr, Stanford, CA 94305, USA
| | - Patrick Ye
- Department of Radiology, Stanford University, 1201 Welch Rd, Stanford, CA 94034, USA
| | - Kim Butts Pauly
- Department of Radiology, Stanford University, 1201 Welch Rd, Stanford, CA 94034, USA
| | - Tirin Moore
- Department of Neurobiology, Stanford University, 318 Campus Dr, Stanford, CA 94305, USA
| | - William Newsome
- Department of Neurobiology, Stanford University, 318 Campus Dr, Stanford, CA 94305, USA
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75
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Razavi M, Zheng F, Telichko A, Ullah M, Dahl J, Thakor AS. Effect of Pulsed Focused Ultrasound on the Native Pancreas. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:630-638. [PMID: 31882169 PMCID: PMC7010559 DOI: 10.1016/j.ultrasmedbio.2019.11.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 11/06/2019] [Accepted: 11/22/2019] [Indexed: 05/25/2023]
Abstract
Pulsed focused ultrasound (pFUS) utilizes short cycles of sound waves to mechanically shake cells within tissues which, in turn, causes transient local increases in cytokines, growth factors and cell adhesion molecules. Although the effect of pFUS has been investigated in several different organs including the kidney, muscle and heart, its effect on the pancreas has not been investigated. In the present work, we applied pFUS to the rodent pancreas with the following parameters: 1.1-MHz frequency, 5-Hz pulse repetition frequency, 5% duty cycle, 10-ms pulse length, 160-s duration. Low-intensity pFUS had a spatial average temporal average intensity of 11.5 W/cm2 and a negative peak pressure of 3 MPa; high-intensity pFUS had a spatial average temporal average intensity of 18.5 W/cm2 and negative peak pressure of 4 MPa. Here we found that pFUS changed the expression of several cytokines while having no effect on the underlying tissue histology or health of pancreatic cells (as reflected by no significant change in plasma levels of amylase and lipase). Furthermore, we found that this effect on cytokine expression in the pancreas was acoustic intensity dependent; while pFUS at low intensities turned off the expression of several cytokines, at high intensities it had the opposite effect and turned on the expression of these cytokines. The ability to non-invasively manipulate the microenvironment of the pancreas using sound waves could have profound implications for priming and modulating this organ for the application of cellular therapies in the context of both regenerative medicine (i.e., diabetes and pancreatitis) and oncology (i.e., pancreatic cancer).
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Affiliation(s)
- Mehdi Razavi
- Interventional Regenerative Medicine and Imaging Laboratory, Department of Radiology, Stanford University School of Medicine, Palo Alto, California 94304, USA; Biionix (Bionic Materials, Implants & Interfaces) Cluster, Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Fengyang Zheng
- Interventional Regenerative Medicine and Imaging Laboratory, Department of Radiology, Stanford University School of Medicine, Palo Alto, California 94304, USA; Department of Ultrasound, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai, China
| | - Arsenii Telichko
- Interventional Regenerative Medicine and Imaging Laboratory, Department of Radiology, Stanford University School of Medicine, Palo Alto, California 94304, USA
| | - Mujib Ullah
- Interventional Regenerative Medicine and Imaging Laboratory, Department of Radiology, Stanford University School of Medicine, Palo Alto, California 94304, USA
| | - Jeremy Dahl
- Interventional Regenerative Medicine and Imaging Laboratory, Department of Radiology, Stanford University School of Medicine, Palo Alto, California 94304, USA
| | - Avnesh S Thakor
- Interventional Regenerative Medicine and Imaging Laboratory, Department of Radiology, Stanford University School of Medicine, Palo Alto, California 94304, USA.
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76
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Sanguinetti JL, Hameroff S, Smith EE, Sato T, Daft CMW, Tyler WJ, Allen JJB. Transcranial Focused Ultrasound to the Right Prefrontal Cortex Improves Mood and Alters Functional Connectivity in Humans. Front Hum Neurosci 2020; 14:52. [PMID: 32184714 PMCID: PMC7058635 DOI: 10.3389/fnhum.2020.00052] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 02/04/2020] [Indexed: 01/21/2023] Open
Abstract
Transcranial focused ultrasound (tFUS) is an emerging method for non-invasive neuromodulation akin to transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). tFUS offers several advantages over electromagnetic methods including high spatial resolution and the ability to reach deep brain targets. Here we describe two experiments assessing whether tFUS could modulate mood in healthy human volunteers by targeting the right inferior frontal gyrus (rIFG), an area implicated in mood and emotional regulation. In a randomized, placebo-controlled, double-blind study, participants received 30 s of 500 kHz tFUS or a placebo control. Visual Analog Mood Scales (VAMS) assessed mood four times within an hour (baseline and three times after tFUS). Participants who received tFUS reported an overall increase in Global Affect (GA), an aggregate score from the VAMS scale, indicating a positive shift in mood. Experiment 2 examined resting-state functional (FC) connectivity using functional magnetic resonance imaging (fMRI) following 2 min of 500 kHz tFUS at the rIFG. As in Experiment 1, tFUS enhanced self-reported mood states and also decreased FC in resting state networks related to emotion and mood regulation. These results suggest that tFUS can be used to modulate mood and emotional regulation networks in the prefrontal cortex.
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Affiliation(s)
- Joseph L Sanguinetti
- Department of Psychology, University of Arizona, Tucson, AZ, United States.,Center for Consciousness Studies, University of Arizona, Tucson, AZ, United States.,Department of Psychology, The University of New Mexico, Albuquerque, NM, United States
| | - Stuart Hameroff
- Department of Psychology, University of Arizona, Tucson, AZ, United States.,Center for Consciousness Studies, University of Arizona, Tucson, AZ, United States.,Department of Anesthesiology, University of Arizona, Tucson, AZ, United States
| | - Ezra E Smith
- Department of Psychology, University of Arizona, Tucson, AZ, United States.,New York State Psychiatric Institute, New York, NY, United States
| | - Tomokazu Sato
- The Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA, United States
| | - Chris M W Daft
- River Sonic Solutions LLC, San Francisco, CA, United States
| | - William J Tyler
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States
| | - John J B Allen
- Department of Psychology, University of Arizona, Tucson, AZ, United States
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77
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Gaur P, Casey KM, Kubanek J, Li N, Mohammadjavadi M, Saenz Y, Glover GH, Bouley DM, Pauly KB. Histologic safety of transcranial focused ultrasound neuromodulation and magnetic resonance acoustic radiation force imaging in rhesus macaques and sheep. Brain Stimul 2020; 13:804-814. [PMID: 32289711 DOI: 10.1016/j.brs.2020.02.017] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 02/15/2020] [Accepted: 02/17/2020] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Neuromodulation by transcranial focused ultrasound (FUS) offers the potential to non-invasively treat specific brain regions, with treatment location verified by magnetic resonance acoustic radiation force imaging (MR-ARFI). OBJECTIVE To investigate the safety of these methods prior to widespread clinical use, we report histologic findings in two large animal models following FUS neuromodulation and MR-ARFI. METHODS Two rhesus macaques and thirteen Dorset sheep were studied. FUS neuromodulation was targeted to the primary visual cortex in rhesus macaques and to subcortical locations, verified by MR-ARFI, in eleven sheep. Both rhesus macaques and five sheep received a single FUS session, whereas six sheep received repeated sessions three to six days apart. The remaining two control sheep did not receive ultrasound but otherwise underwent the same anesthetic and MRI procedures as the eleven experimental sheep. Hematoxylin and eosin-stained sections of brain tissue (harvested zero to eleven days following FUS) were evaluated for tissue damage at FUS and control locations as well as tissue within the path of the FUS beam. TUNEL staining was used to evaluate for the presence of apoptosis in sheep receiving high dose FUS. RESULTS No FUS-related pre-mortem histologic findings were observed in the rhesus macaques or in any of the examined sheep. Extravascular red blood cells (RBCs) were present within the meninges of all sheep, regardless of treatment group. Similarly, small aggregates of perivascular RBCs were rarely noted in non-target regions of neural parenchyma of FUS-treated (8/11) and untreated (2/2) sheep. However, no concurrent histologic abnormalities were observed, consistent with RBC extravasation occurring as post-mortem artifact following brain extraction. Sheep within the high dose FUS group were TUNEL-negative at the targeted site of FUS. CONCLUSIONS The absence of FUS-related histologic findings suggests that the neuromodulation and MR-ARFI protocols evaluated do not cause tissue damage.
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Affiliation(s)
- Pooja Gaur
- Department of Radiology, Stanford University, Stanford, CA, USA.
| | - Kerriann M Casey
- Department of Comparative Medicine, Stanford University, Stanford, CA, USA
| | - Jan Kubanek
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
| | - Ningrui Li
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | | | - Yamil Saenz
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Gary H Glover
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Donna M Bouley
- Department of Comparative Medicine, Stanford University, Stanford, CA, USA
| | - Kim Butts Pauly
- Department of Radiology, Stanford University, Stanford, CA, USA
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78
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Duc NM, Keserci B. Emerging clinical applications of high-intensity focused ultrasound. ACTA ACUST UNITED AC 2020; 25:398-409. [PMID: 31287428 DOI: 10.5152/dir.2019.18556] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
High-intensity focused ultrasound (HIFU) is a minimally-invasive and non-ionizing promising technology and has been assessed for its role in the treatment of not only primary tumors but also metastatic lesions under the guidance of ultrasound or magnetic resonance imaging. Its performance is notably effective in neurologic, genitourinary, hepato-pancreato-biliary, musculoskeletal, oncologic, and other miscellaneous applications. In this article, we reviewed the emerging technology of HIFU and its clinical applications.
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Affiliation(s)
- Nguyen Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Bilgin Keserci
- Department of Radiology, Universiti Sains Malaysia School of Medical Sciences, Kelantan, Malaysia; Department of Radiology, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
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79
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Izadifar Z, Izadifar Z, Chapman D, Babyn P. An Introduction to High Intensity Focused Ultrasound: Systematic Review on Principles, Devices, and Clinical Applications. J Clin Med 2020; 9:jcm9020460. [PMID: 32046072 PMCID: PMC7073974 DOI: 10.3390/jcm9020460] [Citation(s) in RCA: 155] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 01/29/2020] [Accepted: 02/01/2020] [Indexed: 12/22/2022] Open
Abstract
Ultrasound can penetrate deep into tissues and interact with human tissue via thermal and mechanical mechanisms. The ability to focus an ultrasound beam and its energy onto millimeter-size targets was a significant milestone in the development of therapeutic applications of focused ultrasound. Focused ultrasound can be used as a non-invasive thermal ablation technique for tumor treatment and is being developed as an option to standard oncologic therapies. High-intensity focused ultrasound has now been used for clinical treatment of a variety of solid malignant tumors, including those in the pancreas, liver, kidney, bone, prostate, and breast, as well as uterine fibroids and soft-tissue sarcomas. Magnetic resonance imaging and Ultrasound imaging can be combined with high intensity focused ultrasound to provide real-time imaging during ablation. Magnetic resonance guided focused ultrasound represents a novel non-invasive method of treatment that may play an important role as an alternative to open neurosurgical procedures for treatment of a number of brain disorders. This paper briefly reviews the underlying principles of HIFU and presents current applications, outcomes, and complications after treatment. Recent applications of Focused ultrasound for tumor treatment, drug delivery, vessel occlusion, histotripsy, movement disorders, and vascular, oncologic, and psychiatric applications are reviewed, along with clinical challenges and potential future clinical applications of HIFU.
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Affiliation(s)
- Zahra Izadifar
- Division of Biomedical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK S7N 5A9, Canada
- Correspondence: ; Tel.: +1-306-966-7827; Fax: +1-306-966-4651
| | - Zohreh Izadifar
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115, USA
| | - Dean Chapman
- Anatomy & Cell Biology, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Paul Babyn
- Department of Medical Imaging, Royal University Hospital, Saskatoon, SK S7N 0W8, Canada
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80
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Lee J, Chang WS, Shin J, Seo Y, Kong C, Song BW, Na YC, Kim BS, Chang JW. Non-invasively enhanced intracranial transplantation of mesenchymal stem cells using focused ultrasound mediated by overexpression of cell-adhesion molecules. Stem Cell Res 2020; 43:101726. [PMID: 32028085 DOI: 10.1016/j.scr.2020.101726] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 01/16/2020] [Accepted: 01/29/2020] [Indexed: 12/11/2022] Open
Abstract
Although there have been reports of promising results regarding the transplantation of mesenchymal stem cells (MSCs) for neurodegenerative diseases through the use of neuronal differentiation or control of the microenvironment, traditional surgical transplantation methods like parenchymal or intravenous injection have limitations such as secondary injuries in the brain, infection, and low survival rate of stem cells in the target site. Focused ultrasound (FUS) treatment is an emerging modality for the treatment of brain diseases, including neurodegenerative disorders. The various biological effects of FUS treatment have been investigated; therefore, the goal is now to improve the delivery efficiency and function of MSCs by capitalizing on the advantages of FUS. In this study, we demonstrated that FUS increases MSC transplantation into brain tissue by >2-fold, and that this finding might be related to the activation of intercellular adhesion molecule-1 in endothelial and subendothelial cells and vascular adhesion molecule-1 in endothelial cells.
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Affiliation(s)
- Jihyeon Lee
- Brain Korea 21 PLUS Project for Medical Science & Brain Research Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; Department of Neurosurgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Won Seok Chang
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
| | - Jaewoo Shin
- Brain Korea 21 PLUS Project for Medical Science & Brain Research Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; Department of Neurosurgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Younghee Seo
- Brain Korea 21 PLUS Project for Medical Science & Brain Research Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; Department of Neurosurgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Chanho Kong
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Byeong-Wook Song
- Biomedical Research Institute, International St. Mary's Hospital, Incheon Metropolitan City 22711, Republic of Korea; Department of Medical Science, Catholic Kwandong University College of Medicine, Gangneung 25601, Republic of Korea
| | - Young Cheol Na
- Department of Neurosurgery, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon Metropolitan City 22711, Republic of Korea
| | - Bong Soo Kim
- Biomedical Research Institute, International St. Mary's Hospital, Incheon Metropolitan City 22711, Republic of Korea; Department of Medical Science, Catholic Kwandong University College of Medicine, Gangneung 25601, Republic of Korea
| | - Jin Woo Chang
- Brain Korea 21 PLUS Project for Medical Science & Brain Research Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea; Department of Neurosurgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
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81
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Wang H, Zhou X, Cui D, Liu R, Tan R, Wang X, Liu Z, Yin T. Comparative Study of Transcranial Magneto-Acoustic Stimulation and Transcranial Ultrasound Stimulation of Motor Cortex. Front Behav Neurosci 2019; 13:241. [PMID: 31680896 PMCID: PMC6798265 DOI: 10.3389/fnbeh.2019.00241] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 09/24/2019] [Indexed: 11/13/2022] Open
Abstract
Transcranial ultrasound stimulation (TUS; f < 1 MHz) is a promising approach to non-invasive brain stimulation. Transcranial magneto-acoustic stimulation (TMAS) is a technique of neuromodulation for regulating neuroelectric-activity utilizing a magnetic–acoustic coupling electric field generated by low-intensity ultrasound and magnetic fields. However, both techniques use the physical means of low-intensity ultrasound and can induce the response of the motor cortex. Therefore, it is necessary to distinguish the difference between the two techniques in the regulation of neural activity. This study is the first to quantify the amplitude and response latency of motor cortical electromyography (EMG) in mice induced by TMAS and TUS. The amplitude of EMG (2.73 ± 0.32 mV) induced by TMAS was significantly greater than that induced by TUS (2.22 ± 0.33 mV), and the EMG response latency induced by TMAS (101.25 ± 88.4 ms) was significantly lower than that induced by TUS (181.25 ± 158.4 ms). This shows that TMAS can shorten the response time of nerve activity and enhance the neuromodulation effect of TUS on the motor cortex. This provides a theoretical basis for revealing the physiological mechanisms of TMAS and the treatment of neuropsychiatric diseases using it.
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Affiliation(s)
- Huiqin Wang
- Peking Union Medical College, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Tianjin, China
| | - Xiaoqing Zhou
- Peking Union Medical College, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Tianjin, China
| | - Dong Cui
- Peking Union Medical College, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Tianjin, China
| | - Ruixu Liu
- Peking Union Medical College, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Tianjin, China
| | - Ruxin Tan
- Peking Union Medical College, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Tianjin, China
| | - Xin Wang
- Peking Union Medical College, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Tianjin, China
| | - Zhipeng Liu
- Peking Union Medical College, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Tianjin, China
| | - Tao Yin
- Peking Union Medical College, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences, Tianjin, China
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82
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Wang P, Zhang J, Yu J, Smith C, Feng W. Brain Modulatory Effects by Low-Intensity Transcranial Ultrasound Stimulation (TUS): A Systematic Review on Both Animal and Human Studies. Front Neurosci 2019; 13:696. [PMID: 31396029 PMCID: PMC6667677 DOI: 10.3389/fnins.2019.00696] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 06/19/2019] [Indexed: 01/09/2023] Open
Abstract
Background and objective: Low Intensity Transcranial Ultrasound Stimulation (TUS) is a new form of non-invasive brain modulation with promising data; however, systematic reviews on the brain modulatory effects of TUS on both animals and humans have not been well-conducted. We aimed to conduct a systematic review on the studies using the TUS to modulate the brain functions and associated behavioral changes in both animals and humans. Methods: A literature search for published studies in the past 10 years was conducted. Two authors independently reviewed the relevant articles. Data were extracted and qualitatively summarized. Quality of studies was assessed by the SYRCLE's risk of bias tool for preclinical studies or the PEDro scale for clinical studies. Results: A total of 24 animal studies (506 animals) and 11 human studies (213 subjects) were included. Findings based on most animal studies demonstrated the excitatory or suppressive modulatory effects of ultrasonic stimulations on motor cortex, somatosensory cortex, thalamus, prefrontal cortex, auditory, and visual areas. Brain modulatory effects also were found among healthy human subjects in seven studies and two clinical studies suggested TUS may result in potential benefits on patients with disorder of consciousness or chronic pain. The safety concerns of TUS seem to be minor based on the human studies. Conclusions: TUS appears to be a viable technique in modulating the brain functions; however, research on TUS is still in its early stages, especially in human studies. Parameters need to be optimized before launching systematic investigations in humans.
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Affiliation(s)
- Pu Wang
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jiaqi Zhang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jiadan Yu
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, China
| | - Colin Smith
- Department of Neurology, Medical University of South Carolina, Charleston, SC, United States
| | - Wuwei Feng
- Department of Neurology, Medical University of South Carolina, Charleston, SC, United States
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83
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Ultrasound Sensor-Based Wireless Power Transfer for Low-Power Medical Devices. JOURNAL OF LOW POWER ELECTRONICS AND APPLICATIONS 2019. [DOI: 10.3390/jlpea9030020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ultrasonic power transfer (UPT) is a promising method for wireless power transfer technology for low-power medical applications. Most portable or wearable medical devices are battery-powered. Batteries cannot be used for a long time and require periodic charging or replacement. UPT is a candidate technology for solving this problem. In this work, a 40-KHz ultrasound transducer was used to design a new prototype for supplying power to a wearable heart rate sensor for medical application. The implemented system consists of a power unit and heart rate measurement unit. The power unit includes an ultrasonic transmitter and receiver, rectifier, boost converter and super-capacitors. The heart rate measurement unit comprises measurement and monitoring circuits. UPT-based transfer power and efficiency were achieved using 1-, 4- and 8-Farad (F) super-capacitors. At 4 F, the system achieved 69.4% transfer efficiency and 0.318 mW power at 4 cm. In addition, 97% heart rate measurement accuracy was achieved relative to the benchmark device. The heart rate measurements were validated with statistical analysis. Our results show that this work outperforms previous works in terms of transfer power and efficiency with a 4-cm gap between the ultrasound transmitter and receiver.
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84
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Ranjan M, Boutet A, Bhatia S, Wilfong A, Hader W, Lee MR, Rezai AR, Adelson PD. Neuromodulation beyond neurostimulation for epilepsy: scope for focused ultrasound. Expert Rev Neurother 2019; 19:937-943. [PMID: 31232614 DOI: 10.1080/14737175.2019.1635013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Introduction: Epilepsy is one of the most common neurological disorders and is often difficult to control with medication. Intractable epilepsy often results in compromised quality of life (QOL), neurologic morbidity and even mortality. In carefully selected cases, resective surgery offers the best potential for cure or seizure control. However, a large proportion of patients are not suitable for resective epilepsy surgery. Neuromodulation techniques are increasingly being used to treat such refractory cases. Recently, the FDA approved Magnetic Resonance-guided Focused Ultrasound (MRgFUS) for essential tremor and this novel technology is also being explored in several other neuropsychiatric conditions and neurological disorders, including epilepsy. Area covered: While the literature is scant and scattered, the pertinent literature of the MRgFUS is reviewed with an emphasis on research relevant to its application for epilepsy. Expert opinion: Limited preliminary clinical experiences and research studies with MRgFUS ablation or neuromodulation for epilepsy have shown promising results; however, this procedure remains experimental requiring further investigations. Safe and reversible opening of the blood-brain barrier (BBB) with MRgFUS adds an additional therapeutic avenue by allowing targeted delivery of neurotherapeutics in neurological disorders, potentially including epilepsy. Ongoing clinical trials and research coupled with technological advancements contribute to strengthening the MRgFUS epilepsy field. MRgFUS could be the future technology of choice for 'ablation' or 'sononeuromodulation', and/or a 'targeted therapeutics' for epilepsy.
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Affiliation(s)
- Manish Ranjan
- Department of Neurosurgery, West Virginia University , Morgantown , WV , USA.,Neurosurgery, Rockefeller Neuroscience Institute , Morgantown , WV , USA
| | - Alexandre Boutet
- Joint Department of Medical Imaging, University of Toronto , Toronto , ON , Canada
| | - Sanjiv Bhatia
- Division of Pediatric Neurological Surgery, Nicklaus Children's Hospital Brain Institute, University of Miami , Miami , FL , USA
| | - Angus Wilfong
- Division of Neurology, BARROW Neurological Institute at Phoenix Children's Hospital , Phoenix , AZ , USA
| | - Walter Hader
- Division of Pediatric Neurosurgery, Department of clinical neurosciences, University of Calgary , Calgary , AB , Canada
| | - Mark R Lee
- Department of Neurosurgery, West Virginia University , Morgantown , WV , USA.,Neurosurgery, Rockefeller Neuroscience Institute , Morgantown , WV , USA
| | - Ali R Rezai
- Department of Neurosurgery, West Virginia University , Morgantown , WV , USA.,Neurosurgery, Rockefeller Neuroscience Institute , Morgantown , WV , USA
| | - P David Adelson
- Division of Pediatric Neurosurgery, BARROW Neurological Institute at Phoenix Children's Hospital , Phoenix , AZ , USA
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85
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Chen H, Garcia-Gonzalez D, Jérusalem A. Computational model of the mechanoelectrophysiological coupling in axons with application to neuromodulation. Phys Rev E 2019; 99:032406. [PMID: 30999419 DOI: 10.1103/physreve.99.032406] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Indexed: 02/06/2023]
Abstract
For more than half a century, the action potential (AP) has been considered a purely electrical phenomenon. However, experimental observations of membrane deformations occurring during APs have revealed that this process also involves mechanical features. This discovery has recently fuelled a controversy on the real nature of APs: whether they are mechanical or electrical. In order to examine some of the modern hypotheses regarding APs, we propose here a coupled mechanoelectrophysiological membrane finite-element model for neuronal axons. The axon is modeled as an axisymmetric thin-wall cylindrical tube. The electrophysiology of the membrane is modeled using the classic Hodgkin-Huxley (H-H) equations for the Nodes of Ranvier or unmyelinated axons and the cable theory for the internodal regions, whereas the axonal mechanics is modeled by means of viscoelasticity theory. Membrane potential changes induce a strain gradient field via reverse flexoelectricity, whereas mechanical pulses result in an electrical self-polarization field following the direct flexoelectric effect, in turn influencing the membrane potential. Moreover, membrane deformation also alters the values of membrane capacitance and resistance in the H-H equation. These three effects serve as the fundamental coupling mechanisms between the APs and mechanical pulses in the model. A series of numerical studies was systematically conducted to investigate the consequences of interaction between the APs and mechanical waves on both myelinated and unmyelinated axons. Simulation results illustrate that the AP is always accompanied by an in-phase propagating membrane displacement of ≈1nm, whereas mechanical pulses with enough magnitude can also trigger APs. The model demonstrates that mechanical vibrations, such as the ones arising from ultrasound stimulations, can either annihilate or enhance axonal electrophysiology depending on their respective directionality and frequency. It also shows that frequency of pulse repetition can also enhance signal propagation independently of the amplitude of the signal. This result not only reconciles the mechanical and electrical natures of the APs but also provides an explanation for the experimentally observed mechanoelectrophysiological phenomena in axons, especially in the context of ultrasound neuromodulation.
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Affiliation(s)
- Haoyu Chen
- Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, United Kingdom
| | | | - Antoine Jérusalem
- Department of Engineering Science, University of Oxford, Oxford OX1 3PJ, United Kingdom
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86
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Lemaire T, Neufeld E, Kuster N, Micera S. Understanding ultrasound neuromodulation using a computationally efficient and interpretable model of intramembrane cavitation. J Neural Eng 2019; 16:046007. [PMID: 30952150 DOI: 10.1088/1741-2552/ab1685] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Low-intensity focused ultrasound stimulation (LIFUS) emerges as an attracting technology for noninvasive modulation of neural circuits, yet the underlying action mechanisms remain unclear. The neuronal intramembrane cavitation excitation (NICE) model suggests that LIFUS excites neurons through a complex interplay between microsecond-scale mechanical oscillations of so-called sonophores in the plasma membrane and the development of a millisecond-scale electrical response. This model predicts cell-type-specific responses that correlate indirectly with experimental data, but it is computationally expensive and difficult to interpret, which hinders its potential validation. Here, we introduce a multi-scale optimized neuronal intramembrane cavitation (SONIC) model to achieve fast, accurate simulations and confer interpretability in terms of effective electrical response. APPROACH The NICE system is recast in terms of smoothly evolving differential variables affected by cycle averaged internal variables that are a function of sonophore size and charge density, stimulus frequency and pressure amplitude. Problem separation allows to precompute lookup tables for these functions, which are interpolated at runtime to compute coarse-grained, electrophysiologically interpretable and spatially distributed predictions of neural responses. MAIN RESULTS The SONIC model accelerates computation by more than three orders of magnitude, accurately captures millisecond-scale electrical responses of various cortical and thalamic neurons and offers an increased interpretability to the effects of ultrasonic stimuli in terms of effective membrane dynamics. Using this model, we explain how different spiking behaviors can be achieved in cortical neurons by varying LIFUS parameters, and interpret predictions of spike amplitude and firing rate in light of the effective electrical system. We demonstrate the substantial influence of sonophore size on excitation thresholds, and use a nanoscale spatially extended SONIC model to suggest that partial sonophore membrane coverage has a limited impact on neuronal excitability. SIGNIFICANCE By providing an electrophysiologically interpretable description, the SONIC model clarifies cell-type-specific LIFUS neuromodulation according to the intramembrane cavitation hypothesis.
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Affiliation(s)
- Théo Lemaire
- Translational Neural Engineering Laboratory, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
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87
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Folloni D, Verhagen L, Mars RB, Fouragnan E, Constans C, Aubry JF, Rushworth MFS, Sallet J. Manipulation of Subcortical and Deep Cortical Activity in the Primate Brain Using Transcranial Focused Ultrasound Stimulation. Neuron 2019. [PMID: 30765166 DOI: 10.1101/342303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The causal role of an area within a neural network can be determined by interfering with its activity and measuring the impact. Many current reversible manipulation techniques have limitations preventing their application, particularly in deep areas of the primate brain. Here, we demonstrate that a focused transcranial ultrasound stimulation (TUS) protocol impacts activity even in deep brain areas: a subcortical brain structure, the amygdala (experiment 1), and a deep cortical region, the anterior cingulate cortex (ACC, experiment 2), in macaques. TUS neuromodulatory effects were measured by examining relationships between activity in each area and the rest of the brain using functional magnetic resonance imaging (fMRI). In control conditions without sonication, activity in a given area is related to activity in interconnected regions, but such relationships are reduced after sonication, specifically for the targeted areas. Dissociable and focal effects on neural activity could not be explained by auditory confounds.
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Affiliation(s)
- Davide Folloni
- Wellcome Centre for Integrative Neuroimaging (WIN), Department of Experimental Psychology, University of Oxford, Oxford OX1 3SR, UK; Wellcome Centre for Integrative Neuroimaging (WIN), Centre for Functional MRI of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK.
| | - Lennart Verhagen
- Wellcome Centre for Integrative Neuroimaging (WIN), Department of Experimental Psychology, University of Oxford, Oxford OX1 3SR, UK; Wellcome Centre for Integrative Neuroimaging (WIN), Centre for Functional MRI of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK.
| | - Rogier B Mars
- Wellcome Centre for Integrative Neuroimaging (WIN), Centre for Functional MRI of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK; Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6525 HR Nijmegen, the Netherlands
| | - Elsa Fouragnan
- Wellcome Centre for Integrative Neuroimaging (WIN), Department of Experimental Psychology, University of Oxford, Oxford OX1 3SR, UK; School of Psychology, University of Plymouth, Plymouth PL4 8AA, UK
| | - Charlotte Constans
- Physics for Medicine Paris, Inserm, ESPCI Paris, CNRS, PSL Research University, Univ Paris Diderot, Sorbonne Paris Cité, Paris 75012, France
| | - Jean-François Aubry
- Physics for Medicine Paris, Inserm, ESPCI Paris, CNRS, PSL Research University, Paris 75012, France
| | - Matthew F S Rushworth
- Wellcome Centre for Integrative Neuroimaging (WIN), Department of Experimental Psychology, University of Oxford, Oxford OX1 3SR, UK; Wellcome Centre for Integrative Neuroimaging (WIN), Centre for Functional MRI of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
| | - Jérôme Sallet
- Wellcome Centre for Integrative Neuroimaging (WIN), Department of Experimental Psychology, University of Oxford, Oxford OX1 3SR, UK; Wellcome Centre for Integrative Neuroimaging (WIN), Centre for Functional MRI of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK.
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88
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Kim E, Anguluan E, Youn S, Kim J, Hwang JY, Kim JG. Non-invasive measurement of hemodynamic change during 8 MHz transcranial focused ultrasound stimulation using near-infrared spectroscopy. BMC Neurosci 2019; 20:12. [PMID: 30885121 PMCID: PMC6423784 DOI: 10.1186/s12868-019-0493-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 03/12/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Transcranial focused ultrasound (tFUS) attracts wide attention in neuroscience as an effective noninvasive approach to modulate brain circuits. In spite of this, the effects of tFUS on the brain is still unclear, and further investigation is needed. The present study proposes to use near-infrared spectroscopy (NIRS) to observe cerebral hemodynamic change caused by tFUS in a noninvasive manner. RESULTS The results show a transient increase of oxyhemoglobin and decrease of deoxyhemoglobin concentration in the mouse model induced by ultrasound stimulation of the somatosensory cortex with a frequency of 8 MHz but not in sham. In addition, the amplitude of hemodynamics change can be related to the peak intensity of the acoustic wave. CONCLUSION High frequency 8 MHz ultrasound was shown to induce hemodynamic changes measured using NIRS through the intact mouse head. The implementation of NIRS offers the possibility of investigating brain response noninvasively for different tFUS parameters through cerebral hemodynamic change.
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Affiliation(s)
- Evgenii Kim
- School of Electrical Engineering and Computer Science, Gwangju Institute of Science and Technology, Gwangju, 61005 Republic of Korea
| | - Eloise Anguluan
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005 Republic of Korea
| | - Sangyeon Youn
- Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, 42988 Republic of Korea
| | - Jihun Kim
- Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, 42988 Republic of Korea
| | - Jae Youn Hwang
- Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, 42988 Republic of Korea
| | - Jae Gwan Kim
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005 Republic of Korea
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Abstract
For more than 70 years, the promise of noninvasive neuromodulation using focused ultrasound has been growing while diagnostic ultrasound established itself as a foundation of clinical imaging. Significant technical challenges have been overcome to allow transcranial focused ultrasound to deliver spatially restricted energy into the nervous system at a wide range of intensities. High-intensity focused ultrasound produces reliable permanent lesions within the brain, and low-intensity focused ultrasound has been reported to both excite and inhibit neural activity reversibly. Despite intense interest in this promising new platform for noninvasive, highly focused neuromodulation, the underlying mechanism remains elusive, though recent studies provide further insight. Despite the barriers, the potential of focused ultrasound to deliver a range of permanent and reversible neuromodulation with seamless translation from bench to the bedside warrants unparalleled attention and scientific investment. Focused ultrasound boasts a number of key features such as multimodal compatibility, submillimeter steerable focusing, multifocal, high temporal resolution, coregistration, and the ability to monitor delivered therapy and temperatures in real time. Despite the technical complexity, the future of noninvasive focused ultrasound for neuromodulation as a neuroscience and clinical platform remains bright.
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Affiliation(s)
- David P Darrow
- Department of Neurosurgery, University of Minnesota, 420 Delaware St SE, MMC 96, Room D-429, Minneapolis, MN, 55455, USA.
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90
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Pycroft L, Stein J, Aziz T. Deep brain stimulation: An overview of history, methods, and future developments. Brain Neurosci Adv 2018; 2:2398212818816017. [PMID: 32166163 PMCID: PMC7058209 DOI: 10.1177/2398212818816017] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Indexed: 01/06/2023] Open
Abstract
Deep brain stimulation has already revolutionised the clinical management of treatment-resistant movement disorders and offers novel treatment options for an increasing range of neurological and psychiatric illnesses. In this article, we briefly review the history of deep brain stimulation, particularly focusing on the last 50 years, which have seen rapid development in the safety and efficacy of deep brain stimulation. We then discuss the current state of the art in deep brain stimulation, focusing on emerging indications and recent technological advances that have improved the field. Finally, we consider the future developments in technology, technique, and research that will impact deep brain stimulation; particularly focusing on closed-loop stimulation techniques and emerging techniques such as optogenetics, cybersecurity risk, implantation timing, and impediments to undertaking high-quality research.
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Affiliation(s)
- Laurie Pycroft
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - John Stein
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - Tipu Aziz
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
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91
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Yuan Y, Wang X, Yan J, Li X. The effect of anesthetic dose on the motor response induced by low-intensity pulsed ultrasound stimulation. BMC Neurosci 2018; 19:78. [PMID: 30509160 PMCID: PMC6278113 DOI: 10.1186/s12868-018-0476-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 11/22/2018] [Indexed: 01/21/2023] Open
Abstract
Background Low-intensity pulsed ultrasound stimulation (LIPUS) has been proven to be a noninvasive method with high spatial resolution and deep penetration. Previous studies have qualitatively demonstrated that the electromyographic response caused by LIPUS in the mouse motor cortex is affected by the anesthetic state of the mice. However, the quantitative relationship between motor response and anesthetic dose remains unclear. Results Experimental results show that the success rate decreases stepwise as the isoflurane concentration/mouse weight ratio increases (ratios: [0.004%/g, 0.01%/g], success rate: ~ 90%; [0.012%/g, 0.014%/g], ~ 40%; [0.016%/g, 0.018%/g], ~ 7%; 0.024%/g, 0). The latency and duration of EMG increase significantly when the ratio is more than 0.016%/g. Compared with that at ratios from 0.004 to 0.016%/g, normalized EMG amplitude decreases significantly at ratios of 0.018%/g and 0.020%/g. Conclusions Quantitative calculations indicate that the anesthetic dose has a significant regulatory effect on the motor response of mice during LIPUS. Our results have guiding significance for the selection of the anesthetic dose for LIPUS in mouse motor cortex experiments.
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Affiliation(s)
- Yi Yuan
- Institute of Electrical Engineering, Yanshan University, Qinhuangdao, 066004, China.
| | - Xingran Wang
- Institute of Electrical Engineering, Yanshan University, Qinhuangdao, 066004, China
| | - Jiaqing Yan
- College of Electrical and Control Engineering, North China University of Technology, Beijing, 10041, China
| | - Xiaoli Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China.
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92
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Gibson BC, Sanguinetti JL, Badran BW, Yu AB, Klein EP, Abbott CC, Hansberger JT, Clark VP. Increased Excitability Induced in the Primary Motor Cortex by Transcranial Ultrasound Stimulation. Front Neurol 2018; 9:1007. [PMID: 30546342 PMCID: PMC6280333 DOI: 10.3389/fneur.2018.01007] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 11/07/2018] [Indexed: 12/29/2022] Open
Abstract
Background: Transcranial Ultrasound Stimulation (tUS) is an emerging technique that uses ultrasonic waves to noninvasively modulate brain activity. As with other forms of non-invasive brain stimulation (NIBS), tUS may be useful for altering cortical excitability and neuroplasticity for a variety of research and clinical applications. The effects of tUS on cortical excitability are still unclear, and further complications arise from the wide parameter space offered by various types of devices, transducer arrangements, and stimulation protocols. Diagnostic ultrasound imaging devices are safe, commonly available systems that may be useful for tUS. However, the feasibility of modifying brain activity with diagnostic tUS is currently unknown. Objective: We aimed to examine the effects of a commercial diagnostic tUS device using an imaging protocol on cortical excitability. We hypothesized that imaging tUS applied to motor cortex could induce changes in cortical excitability as measured using a transcranial magnetic stimulation (TMS) motor evoked potential (MEP) paradigm. Methods: Forty-three subjects were assigned to receive either verum (n = 21) or sham (n = 22) diagnostic tUS in a single-blind design. Baseline motor cortex excitability was measured using MEPs elicited by TMS. Diagnostic tUS was subsequently administered to the same cortical area for 2 min, immediately followed by repeated post-stimulation MEPs recorded up to 16 min post-stimulation. Results: Verum tUS increased excitability in the motor cortex (from baseline) by 33.7% immediately following tUS (p = 0.009), and 32.4% (p = 0.047) 6 min later, with excitability no longer significantly different from baseline by 11 min post-stimulation. By contrast, subjects receiving sham tUS showed no significant changes in MEP amplitude. Conclusion: These findings demonstrate that tUS delivered via a commercially available diagnostic imaging ultrasound system transiently increases excitability in the motor cortex as measured by MEPs. Diagnostic tUS devices are currently used for internal imaging in many health care settings, and the present results suggest that these same devices may also offer a promising tool for noninvasively modulating activity in the central nervous system. Further studies exploring the use of diagnostic imaging devices for neuromodulation are warranted.
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Affiliation(s)
- Benjamin C. Gibson
- Psychology Clinical Neuroscience Center, Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Joseph L. Sanguinetti
- Psychology Clinical Neuroscience Center, Department of Psychology, University of New Mexico, Albuquerque, NM, United States
- U.S. Army Research Laboratory, Aberdeen Proving Ground, MD, United States
| | - Bashar W. Badran
- Psychology Clinical Neuroscience Center, Department of Psychology, University of New Mexico, Albuquerque, NM, United States
- U.S. Army Research Laboratory, Aberdeen Proving Ground, MD, United States
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, United States
| | - Alfred B. Yu
- U.S. Army Research Laboratory, Aberdeen Proving Ground, MD, United States
| | - Evan P. Klein
- Psychology Clinical Neuroscience Center, Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Christopher C. Abbott
- Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM, United States
| | | | - Vincent P. Clark
- Psychology Clinical Neuroscience Center, Department of Psychology, University of New Mexico, Albuquerque, NM, United States
- Department of Neurosciences, University of New Mexico School of Medicine, Albuquerque, NM, United States
- The Mind Research Network & LBERI, Albuquerque, NM, United States
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